Gender differences in PTSD, depression and neurobehavioral symptoms among OEF/OIF Veterans diagnosed with mild TBI

Iverson KM, Hendricks A, Kimerling R, Meterko M, Stolzmann K, Krengel M, Baker E, Lew H. Gender differences in PTSD, depression and neurobehavioral symptoms among OEF/OIF Veterans diagnosed with mild TBI. Paper presented at: VA HSR&D Field-Based Women's Health Meeting; 2010 Jul 1; Arlington, VA.

Related HSR&D Project(s)

• SDR 08-405 – TBI Evaluation Instruments and Processes for Clinical Follow-up

Objective: Many women Veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have experienced mild traumatic brain injury (mTBI) (Schneiderman, Braver, and Kang, 2008). Treatment approaches accounting for co-morbidities and gender-related concerns are very important (Batten and Pollack, 2008). This analysis describes gender differences in psychiatric and neurobehavioral symptoms experienced by VA patients with deployment-related mTBI. Methods: This population-based investigation included deployed Veterans or active military using VA services, who received a TBI Level 2 Evaluation in VA between 10/1/2007 and 6/30/2009. Men (n = 11,951) and women (n = 654) who were judged to have deployment-related mTBI during the standardized comprehensive evaluation were compared on the presence of psychiatric and neurobehavioral symptoms using chi-square analyses and MANOVAs. Results: 89% of the sample was judged by a VA clinician to have symptoms of at least one psychiatric condition based on the comprehensive evaluation. Women (56.6%) were more likely than men (42.0%) to have symptoms of depression, 2 (1, N = 12,605) = 54.04, p < .0001. Men (75.3%) were more likely than women (68.8%) to have symptoms of posttraumatic stress disorder (PTSD), 2 (1, N = 12,605) = 13.85, p < .001, but women (34.4%) were more likely than men (24.9%) to have symptoms of an anxiety disorder other than PTSD. Women reported significantly more severe neurobehavioral symptoms on all four scales - somatosensory, cognitive, affective and vestibular - created to summarize the self-report symptom severity data from the Neurobehavioral Symptom Inventory-22, administered as part of the Level 2 TBI Evaluation. Conclusions: The majority of men and women OEF/OIF Veterans diagnosed with mTBI from a TBI Level 2 Evaluation experience symptoms of one or more comorbid psychiatric disorders, particularly PTSD and depression. Depression, anxiety disorders other than PTSD, and neurobehavioral symptom severity are behavioral health issues of particular relevance among women Veterans with mTBI. Impacts: Although the associations between TBI and PTSD have received unprecedented attention within the VA, these data suggest that it is also important to assess and treat depression, anxiety and neurobehavioral symptoms among women Veterans with mTBI in order to ensure comprehensive gender-specific care for women.